trying to be a fiance and not just a nurse(long)

[toadie]

my fiance's grandfather is in the hospital and i am not close with my mother-in-law-to-be. i get small bits of info from my fiance but he doesn't really understand what is going on.

so i called his mom to find out what was happening. well, he went in for pneumonia and exacerbation of heart failure. after a week, the day he was to be dc, they found blood in his stool; and so the spiral begins.

turns out he was having bowel issues which was causing problems with flow to his kidneys which led to exacerbation of his heart failure. they took him for emergency surgery and removed his entire large colon on wednesday. started him on intermittent dialysis on thursday.

not sure of what happened between then and now, but my fiance went to visit today and came home with questions about a "feeding tube". a peg. and he also said that he was intubated, im not sure when that happened.

as an icu nurse i've seen this scenario too many times. grampa will be 90 next month. my fiance and his dad want him kept alive "by any means". his mom, who's grampa's daughter doesnt want any of this done. grampa consented to everything, but i have my doubts as to his ability to consent, at his age and in his condition.

i need advise on how to talk with my fiance to get him to understand what is really happening.

[EmmaG, RN]

Sounds like Mom is next of kin, and would have the final say should Grandpa be judged not able to make his own decisions.

Ask the case manager to arrange a meeting for the family and his patient care team to discuss his care and where to go from here. The doc, his primary nurse, the chaplain all would be able to help put it into perspective and assist the family in these decisions. I'd also include a call to the patient advocate, if there is one at the facility and ask them to be present. (not all hospitals have them, but they are wonderful in cases like this). The CM's I've worked with are good at tying it all together and helping families get answers.

I think that route would be much more effective than you trying to do all this. You are essentially a family member, and perhaps you need to step back and take that role, and allow those who are there to care for him help you all through this time. I'm not saying this would happen, but given there is apparent disagreement among the immediate family on how to proceed, you could very well be setting yourself up for future problems with this family if you take on the role of the nurse here.

BTW, if there's an ethics concern, anyone can call for an ethics consult; it doesn't have to be an employee.

Good luck.

[texas_lvn]

no advice, just know you are in my prayers. Talk about a rock and a hard place. Good luck.

editted for spelling. duh.